Oral health changes in Vietnamese children from 1999 to 2007

Objectives: To determine changes in caries and fluorosis rates and oral health behaviour in children in urban Hanoi and in rural LaoCai since 1999. Methods: In 2007, 1084 randomly selected school children from the same schools visited in the 1999 National Oral Health Survey were examined using similar protocols (National Institutes of Health caries guidelines and Dean's Fluorosis Index). The 1999 survey employed a multi-stage stratified random sampling strategy. Parents received an oral health behaviour questionnaire. Results: The mean dmfs for Hanoi 6-8 year olds was 12.25 compared to 8.19 in 1999. Corresponding values for LaoCai were 12.49 and 11.47. DMFS for 12-14 year olds were 2.60 compared to 2.39 in Hanoi and 1.58 compared to 3.69 in LaoCai. Fluorosis prevalence among 12-14 year olds doubled to 46.9% (predominantly questionable or mild) in Hanoi and decreased slightly to 9.5% in LaoCai. The proportion of children who started using toothpaste at 3 years or younger increased from 25% (26% don't know) to 44% (10%) in Hanoi and from 15% (23%) to 35% (18%) in LaoCai. Reported frequency of toothbrushing x2 or +/day increased from 60% to 69% in Hanoi and from 44% to 69% in LaoCai. Reported use of fluoride toothpaste increased from 77% (22% don't know) to 91% (8%) in Hanoi but did not vary in LaoCai, 71% (27%) and 71% (25%). Conclusions: Between 1999 and 2007 caries experience in 12-14 year olds increased marginally in urban Hanoi and decreased in rural LaoCai. Caries experience in 6-8 year olds increased, particularly in Hanoi. The relatively late age of introduction of fluoride toothpaste limits its preventive impact on the primary dentition. Development of the Vietnamese economy has been more rapid in Hanoi with possible increases in cariogenic diets only partly ameliorated by increased exposure to fluoride in toothpaste.